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Ambulance Utilization in New York City after the Implementation of the Affordable Care Act

Author

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  • Courtemanche, Charles

    () (Georgia State University)

  • Friedson, Andrew I.

    () (University of Colorado Denver)

  • Rees, Daniel I.

    () (University of Colorado Denver)

Abstract

Expanding insurance coverage could, by insulating patients from having to pay full cost, encourage the utilization of arguably unnecessary medical services. It could also eliminate (or at least diminish) the need for emergency services through increasing access to preventive care. Using publicly available data from New York City for the period 2013-2016, we explore the effect of the Affordable Care Act (ACA) on the volume and composition of ambulance dispatches. Consistent with the argument that expanding insurance coverage encourages the utilization of unnecessary medical services, we find that, as compared to dispatches for more severe injuries, dispatches for minor injuries rose sharply after the implementation of the ACA. By contrast, dispatches for pre-labor pregnancy complications decreased as compared to dispatches for women in labor.

Suggested Citation

  • Courtemanche, Charles & Friedson, Andrew I. & Rees, Daniel I., 2018. "Ambulance Utilization in New York City after the Implementation of the Affordable Care Act," IZA Discussion Papers 11444, Institute for the Study of Labor (IZA).
  • Handle: RePEc:iza:izadps:dp11444
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    References listed on IDEAS

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    1. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    2. Charles Courtemanche & James Marton & Aaron Yelowitz, 2016. "Who Gained Insurance Coverage in 2014, the First Year of Full ACA Implementation?," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 778-784, June.
    3. Courtemanche, Charles & Marton, James & Ukert, Benjamin & Yelowitz, Aaron & Zapata, Daniela, 2017. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health," IZA Discussion Papers 10649, Institute for the Study of Labor (IZA).
    4. Leon S. Moskatel & David J.G. Slusky, 2017. "Did UberX Reduce Ambulance Volume?," WORKING PAPERS SERIES IN THEORETICAL AND APPLIED ECONOMICS 201708, University of Kansas, Department of Economics, revised Oct 2017.
    5. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
    6. Charles Courtemanche & Andrew Friedson & Andrew P. Koller & Daniel I. Rees, 2017. "The Affordable Care Act and Ambulance Response Times," NBER Working Papers 23722, National Bureau of Economic Research, Inc.
    7. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    8. Miller, Sarah, 2012. "The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform," Journal of Public Economics, Elsevier, vol. 96(11), pages 893-908.
    9. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    10. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    11. repec:wly:jpamgt:v:36:y:2017:i:1:p:178-210 is not listed on IDEAS
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    More about this item

    Keywords

    Affordable Care Act; ambulance; emergency medical service; health insurance; moral hazard;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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